title: Barrow-in-Furness: a large community legionellosis outbreak in the UK.
abstract: A community outbreak of legionellosis occurred in Barrow-in-Furness, Cumbria, during July and August 2002. A descriptive study and active case-finding were instigated and all known wet cooling systems and other potential sources were investigated. Genotypic and phenotypic analysis, and amplified fragment length polymorphism of clinical human and environmental isolates confirmed the air-conditioning unit of a council-owned arts and leisure centre to be the source of infection. Subsequent sequence-based typing confirmed this link. One hundred and seventy-nine cases, including seven deaths [case fatality rate (CFR) 3·9%] were attributed to the outbreak. Timely recognition and management of the incident very likely led to the low CFR compared to other outbreaks. The outbreak highlights the responsibility associated with managing an aerosol-producing system, with the potential to expose and infect a large proportion of the local population and the consequent legal ramifications and human cost.
authors.affiliation: Emergency Response Department,Public Health England,Salisbury,UK.
authors.forename: E
authors.initials: E
authors.lastname: Bennett
authors.affiliation: Knowsley Metropolitan Borough Council,Knowsley, Merseyside,UK.
authors.forename: M
authors.initials: M
authors.lastname: Ashton
authors.affiliation: Public Health England,Penrith, Cumbria,UK.
authors.forename: N
authors.initials: N
authors.lastname: Calvert
authors.affiliation: NHS Fylde and Wyre, Fylde and Wyre,UK.
authors.forename: J
authors.initials: J
authors.lastname: Chaloner
authors.affiliation: Lancashire Teaching Hospitals,NHS Foundation Trust,Lancashire,UK.
authors.forename: J
authors.initials: J
authors.lastname: Cheesbrough
authors.affiliation: Emergency Response Department,Public Health England,Salisbury,UK.
authors.forename: J
authors.initials: J
authors.lastname: Egan
authors.affiliation: North West Regional Microbiologist, Health Protection Agency, Warrington,UK.
authors.forename: I
authors.initials: I
authors.lastname: Farrell
authors.affiliation: Emergency Response Department,Public Health England,Salisbury,UK.
authors.forename: I
authors.initials: I
authors.lastname: Hall
authors.affiliation: Microbiology Reference Services,Public Health England,London,UK.
authors.forename: T G
authors.initials: TG
authors.lastname: Harrison
authors.affiliation: Centre for Infectious Disease Surveillance and Control (CIDSC),Public Health England,London,UK.
authors.forename: F C
authors.initials: FC
authors.lastname: Naik
authors.affiliation: West Suffolk NHS Foundation Trust,Suffolk,UK.
authors.forename: S
authors.initials: S
authors.lastname: Partridge
authors.affiliation: Public Health England,Cheshire and Merseyside,UK.
authors.forename: Q
authors.initials: Q
authors.lastname: Syed
authors.affiliation: Emergency Response Department,Public Health England,Salisbury,UK.
authors.forename: R N
authors.initials: RN
authors.lastname: Gent
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000401:mortality; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D016952:Legionella pneumophila / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D007876:Legionellosis / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality; D058885:Multilocus Sequence Typing; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult